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Home My WebLink About43541_MILLER, KENNETH_20060111 (2)&FILL aaXEDGE PERMIT Previous permit # ❑New . (Modification ❑Complete Reissue ❑Partial Reissue Date previous permil/,issued As authorized by the State of North Carolina, Department of Environment and Natural Resources and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC O Rul S attached. Applicant Name' ? Project Location: County Addressor : , Street Address/ State Road/ Lot #(s) City ,} State ZIP Phone # Fax # O Subdivision Authorized Agent City__ _ ZIP _ Affected -' CW ❑•EW 0-PTA DES ❑ PTS Phone # (_) River Basin AEC(s): - OEA = HHF ❑ IH ❑ UBA ❑ N/A Adj. Wtr. Body (nat /man /unkn) PWS: ❑ FC: ORW: yes / no PNA yes / no) Crit. Hab. yes / no Closest Maj. Wtr. Body Type of Project/ Activity Pier (dock) length Platform(s) Finger pier(s) Groin length number Bulkhead/ Riprap length avg distance offshore_ max distance offshore Basin, channel cubic yards Boat ramp _ Boathouse/ Boatlift) l •� Beach Bulldozing Other 1 ; Shoreline Length " SAV: not sure yes no _ Sandbags: not sure yes no Moratorium: n/a yes no Photos: yes no _i Waiver Attached: yes `nIo A building permit may be required by: Notes/ Special Conditions Agent or Applicant Signature ** Please read compliance statement on back of.permit is Application Fee(s) Check# (Scale: See note on back regarding River Basin rules. Permit Officer's Signature Issuing Date Expiration Date /s Local Planning Jurisdiction Rover File Name 1 -4 Statement of Compliance and Consistency This permit is subject to compliance with this application, site drawing and attached general and specific conditions. Any violation of these terms may subject the permittee to a fine or criminal or civil action; and may cause the permit to become null and void. This permit must be on the project site and accessible to the permit officer when the project is inspected for compliance. The applicant certifies by signing this permit that 1) prior to undertaking any activities authorized by this permit, the applicant will confer with appropriate local authorities to confirm that this project is consistent with the local land use plan and all local ordinances, and 2) a written statement or certified mail return receipt has been obtained from the adjacent riparian landowner(s) . The State of North Carolina and the Division of Coastal Management, in issuing this permit under the best available information and belief, certifythat this project is consistentwith the North Carolina Coastal Management Program. River Basin Rules Applicable To Your Project: ❑ Tar- Pamlico River Basin Buffer Rules ❑ Other: ❑ Neuse River Basin Buffer Rules If indicated on front of permit, your project is subject to the Environmental Management Commission's Buffer Rules for the River Basin checked above due to its location within that River Basin. These buffer rules are enforced by the NC Division of Water Quality. Contact the Division of Water Quality at the Washington Regional Office (252-946-6481) or the Wilmington Regional Office (910-796-7215) for more information on how to comply with these buffer rules. Division of Coastal Management Offices Central Office Mailing Address: 1638 Mail Service Center Raleigh, NC 27699-1638 Location: Parker -Lincoln Building 2728 Capital Blvd. Raleigh, NC 27604 919-733-2293 Fax:919-733-1495 Elizabeth City District 1367 U.S. 17 South Elizabeth City, NC 27909 252-264-3901 Fax:252-264-3723 (Serves: Camden, Chowan, Currituck, Dare, Gates, Pasquotank and Perquimans Counties) Morehead City District 400 Commerce Ave Morehead City, NC 28557 202-808-2808/ 1-888-4RCOAST Fax: 252-247-3330 (Serves: Carteret, Craven, Onslow -above New River Inlet- and Pamlico Counties) Washington District 943 Washington Square Mall Washington, NC 27889 252-946-6481 Fax: 252-948-0478 (Serves: Beaufort, Bertie, Hertford, Hyde, Tyrrell and Washington Counties) Wilmington District 127 Cardinal Drive Ext. Wilmington, NC 28405-3845 910-796-7215 Fax:910-395-3964 (Serves: Brunswick, New Hanover, Onslow -below New River Inlet- and Pender Counties) Revised 06/29/05 r ` ADJACENT RIPARIAN PROPERTY OWNER STATEMENT-82005 (FOR A PIERAWOORING PILINGS/BOATLIFT/BOATHOUSE) I hereby certify that I own property adjacent to L(217I)e f--�j (Name of Property Owner) property located at .2sy &/,/) (ile e- (Lot, Block, Road, etc.) on \/� j/`e�` , in , N.C. (�'aterbody) (To n and/or County) He has described to me, as shown below, the development he is proposing at that location, and, I have no objections to his proposal. I understand that a pier/mooring pilings/boadift/boathouse must be set back a minimum distance of fifteen feet (15') from my area of riparian access unless waived by me. I Rio not wish to waive the setback requirement. I d_Q wish to waive that setback requirement. DESCRIPTION AND;'OR DRAWI\G OF PROPOSED DEVELOP`IE\T: (To be filled in by individual proposing development) v 1 0 r o a T O - - - - - - - - -------------------------------------------- �--------------------------------j/------------------------- Slznatur; rint or Type Name Telephone Number Date: ADJACENT RIPARIAN PROPERTY OWNER STATEN11ENT (FOR A PIERAVOORING PILINGSIBOATLIFT/BOATHOUSE) I hereby certify that I own property adjacent to(�/'1 C ,� h ° / + I [ I [�s . 6 (Name of Property Owner) property located at (Lot, Block, Road, etc.) {`Jj ( 'aterbody) (To n and/or County) He has described to me, as shown below, the development he is proposing at that location, and, I have no objections to his proposal. I understand that a pier/mooring pilings/boatlift/boathouse must be set back a minimum distance of fifteen feet (15') from my area of riparian access unless waived by me. I do not wish to waive the setback requirement. I dQ wish to waive that setback requirement. DESCRIPTION ANi -D/OR DRAWING OF PROPOSED DEVELOPMENT: (To be filled itz by individual proposing development) .mot —o _ - 5 a �s x bQ ------------------------------------------------------------------------------------------------------ ---------- Si-natur /'/ii�I�T� e N Print or Type Name Telephone Number Date: C� ; R Pr ►pp �rYv tio� V SEA' I t� 2005 orehe City DCM Wg1�L 0 t 13aAi L ►�� .00 R lemo n"7c.RWj d` � 06� 10F 000 " PAY TO THE ORDER OF_ 0 CREDIT " UN 51 m task mas5n MEMO !� 1: 2 53 i:76846�: 7000 7 20988 Sill - -Jw - - - 0 9. KENNETH L' . MILLER NCDL.32A9828 P.O. BOX 91 252,..745-5504 STONEWALL, NC 28583 66-7%4/2531 739 70V2W885 DATE $ lw DOLLARS 8 � `�